Nigeria President Goodluck Jonathan, Global Fund Director Mark Dybul with other Nigeria and Global Fund officials following a meeting in Abuja. Photo: NAN

When, in early January, Nigeria President Goodluck Jonathan signed the Same Sex Marriage Prohibition Act into law, the legislation had been a subject of concern among global health and human rights actors for more than eight years.

Now, however, consideration of how foreign donors financing HIV-fighting efforts in Nigeria willl respond seems to be just beginning. At the same time, those involved in donating have acknowledged that some consideration is necessary to ensure that funding is used effectively in the face of further formalization of homophobic discrimination that has long hampered efforts.

According to news reports in the days that followed the signing, U.S. Ambassador to Nigeria James Enwistle hinted that the new law might impact bilateral HIV funding before issuing assurances that it wouldn’t, and then adding, “I’m not a lawyer, but I read the law and it seems to me that it may put some restrictions on what we can do to help fight HIV/AIDS in this country.” Senator Patrick Leahy, who is a lawyer, was quoted suggesting a rethink of foreign aid in countries with human rights abuses.

At the same time a statement from the Nigerian Coalition for the Defense of Sexual Rights has urged “firm but quiet diplomatic action,” but also asked supporters not to “in any way provoke or threaten the Nigerian government in public or private discussion/dialogue on aid cutting, economic sanctions and embargoes.”

This week, the Global Forum on MSM and HIV has issued a statement endorsed by 83 organizations, including the IDSA Center for Global Health Policy, which produces this blog, calling on global HIV donors including the President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria to take specific actions. Those actions include establishing a civil society task force, redirecting funds toward security, legal help and advocacy for affected groups, scrutinizing use of funds, and barring Nigeria from participating in leadership positions in their responses.

They are moves that suggest a future very different from the months and years leading up to the law’s passage and signing by Jonathan.

He also announced that Nigeria would get $228 million in additional funding for programs to prevent and treat HIV as well as malaria, with the new HIV grants focusing on reaching pregnant women and “most at risk” populations including men who have sex with men. In November, pointing to Nigeria’s commitment to boost its domestic health spending, Dybul referred to Jonathan as a “champion” whose involvement would lead to the day the three diseases would be defeated. But then, a few months later, the confidence that all were working on the same goal began to disintegrate, when Jonathan signed the “Same-sex Marriage Prohibition Act” into law and the Global Fund with UNAIDS issued a statement expressing “deep concern that access to HIV services for lesbian, gay, bisexual and transgender (LGBT) people will be severely affected by a new law in Nigeria––further criminalizing LGBT people, organizations and activities, as well as people who support them.” That is because the law not only prohibits marriage, but gatherings among gay people and threatens those who support gay people with prison as well.

By then, of course, contrary to Nigeria’s National Agency for the Control of AIDS director John Idoko’s assertion that the law would have no impact on access to HIV services, the impact of the country’s already oppressive laws had been noted repeatedly in its own previous Global Fund grant proposals. The proposal for Round 8 funding conceded a “weakness” in measuring the impact of efforts included “Measuring impacts and outcomes on the populations not recognized by law such as MSM and IDU.” The Round 9 proposal allowed that “Legal, policy and religious barriers also prevent service providers from working among some MARPs, such as female sex workers (FSWs), men who have sex with men (MSM) and injecting drug users (IDUs),” and that “These weaknesses reduce the achievements of the prevention outcomes.”

An opinion piece on Brazil’s human rights success story in the New York Times this week answering “Why is Latin America So Progressive on Gay Rights” indicates it doesn’t have to be that way. Its success, the author writes, was built around a fundamental right to health care.